Posts tagged with: insurance

In his famous work, History of Economic Analysis, economist Joseph A. Schumpeter gives a favorable nod to the works of Leonardus Lessius (1554–1623), sparking a fair amount of interest in the 16th-century Jesuit moral theologian.

CLP Academic has now published On Sale, Securities, and Insurance, a selection from Lessius’ most influential contribution to early modern economics, ethics, and law. The book offers the first full English translation of key sections of the second book (On Justice) of Lessius’ treatise On Justice and Right (De iustitia et iure), specifically chapters 21 (On Sale-purchase) and 28 (On Suretyship, Insurance, Pledge, and Mortgage).

Based at the Jesuit College in Louvain, Lessius earned the reputation as “Oracle of the Netherlands” for the advice and analysis he offered to local merchants, jurists, and political rulers regarding matters of conscience, duty, and justice.

As translator Wim Decock writes in the introduction: “Though dwelling on the virtues of prudence, fortitude, and temperance too, the better part of the treatise includes a systematic treatment of the virtue of justice and, particularly, of property, torts, and contract law.” (more…)

My mother, a registered nurse, worked for years for our small town doctor. She would drive around the countryside, going to check on elderly folks or those who didn’t drive. We had a number of people who came to our house regularly for things like allergy shots. She kept their vials of medication, rubbing alcohol, cotton balls and syringes in our kitchen cupboard. The doctor (who was the sort to exchange his services for things like eggs and fresh meat) gave me my kindergarten physical in his living room.

While this might seem like Norman Rockwell, misty-eyed nostalgia, there’s one thing for sure: this doctor and my mom knew their patients really well. They knew their concerns, their histories: not just medical, but in all aspects of their life. Given a choice, isn’t this the kind of medical care most of us would choose for ourselves and our families? (more…)

The White House—having canceled Americans’ old health plans, and having botched the system for enrolling people in new ones—knows that millions of Americans will enter the new year without health coverage. So instead of actually fixing the problem, the administration is retroactively attempting to force insurers to hand out free health care—at a loss—to those whom the White House has rendered uninsured. If Obamacare wasn’t a government takeover of the health insurance industry, then what is it now?

“We have to pass the bill so that you find out what is in it, away from the fog of the controversy.”

Nancy Pelosi was the House Speaker when she made those remarks about Obamacare at the 2010 Legislative Conference for the National Association of Counties. At the time, Pelosi was mocked for not understanding what was in the legislation she was supporting. But the reality is that with all legislation that is considered by Congress, we almost never really know what is in it until it has been passed.

If you took civics class in high school (or just watched Schoolhouse Rock), you likely know how a bill becomes a law. But what most people don’t understand is the process by which a law becomes policy.

We often think that the judiciary is the branch of government responsible for interpreting the law. But in reality most interpretation is done by the executive branch, through the various regulatory agencies. Regulatory agencies handle administrative law, primarily by codifying and enforcing rules and regulations. When Congress passes a new law it usually goes to a regulatory agency to determine how the law will be put in place.(more…)

Of course the calculus to come up with such a conclusion is flawed in myriad ways. But even if we were to assume the veracity of the contention, many questions immediately arise. For instance, why wouldn’t insurance companies voluntarily offer birth control coverage gratis if it would lower their costs? Aren’t these the same profit-maximizing institutions that politicians have been demonizing for years? Aren’t the insurers the professionals, whose business it is to know what ways are available for minimizing exposure? The very fact that up to this point insurance companies have not added free birth control as a preventive care measure is powerful evidence against the economic argument in favor of contraception.(more…)

Among the warnings sounded as the Democratic health care reform bill was being debated was that the federal insurance mandate included in the bill—even though not national health care per se—would essentially give the federal government control of the insurance industry. The reason: If everyone is forced to buy insurance, then the government must deem what sort of insurance qualifies as adequate to meet the mandate. This piece of Obamacare promises to turn every medical procedure into a major political fight, with special interest lobbying rather than objective medical expertise being more likely to determine what kind of health care gets covered and what kind doesn’t.

The problem goes beyond ugly politics, however, and into the realm of moral repugnance. The contention has already started, as the Catholic bishops have formally protested the pending inclusion of contraception and sterilization among items that must be covered in every American insurance plan.

Whether one agrees with Catholic morality is beside the point. The point is that this is no way to deal with a major economic sector in a free, pluralist society. Some medical doctors think chiropractors are quacks; some chiropractors think medical doctors are quacks. Some people think marijuana is an excellent pain killer; others think it is an immoral drug. The goods and services that the 300 million people in this country consider to be effective—or objectionable—instances of health care vary, sometimes dramatically, according to geography, culture, religion, and ethnicity. Now a single institution, the national government in the form of the Department of Health and Human Services, is charged with arbitrating which goods and services make the cut and which don’t. Those who lack the political clout to get their preferences included will pay coming and going: their insurance premiums will cover things that they don’t want and they’ll have to pay out of pocket for things that they do.

The variety offered by a medical market is a beautiful thing. Monolithic medicine mandated by a law that most Americans opposed is not.

I still haven’t quite gotten to a thorough fisking of “Exhibit B,” yet, and will have to be satisfied with arguing the following thesis in the meantime:

It is impossible to increase insurance coverage in America without increasing medical spending.

We cannot save enough on bureaucratic reform and government-induced “competition” to offset the new costs associated with an influx of 40+ million new participants. Certainly the newly mandated premiums, paid by those who have determined for themselves that it is not worth it to pay in to health insurance, will also offset some of the new costs. But how many of those 40+ million uninsured have voluntarily opted out?

If even a large minority, say 1/3 of the uninsured, is made up of those that have been denied coverage outright or cannot afford it because of various health factors (many estimates place that number far higher), then guaranteeing coverage to 15 million new patients will certainly surpass any of the potential gains seen in those other revenue sources. The very reason that so many of these folks do not have insurance coverage is because private firms have determined them to be too risky (that is, too expensive) to cover.

How can we mandate coverage of this group and not increase health care spending? It seems like an impossible promise.

The contention really cannot be that we can spend just as much as we are right now and extend the same qualitative and accessible health coverage to everyone. The honest situation is that we would have to spend more to guarantee coverage, and as a nation we need to decide whether that public good requires governmental mandates, regulations, and administration or if it doesn’t.

There will be new costs. We need to determine whether and how they ought to be borne.